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What to Tell Recovering COVID-19 Patients About Their Recovery Time

Patients recovering from COVID-19 are increasingly asking pharmacists and other healthcare professionals when their symptoms will fully resolve. A CDC survey suggests it can take several weeks, even in younger patients with no co-morbidities. Find out what symptoms are most likely to persist.

ATLANTA – Even in patients who recover at home from COVID-19, the nagging cough, exhaustion and other symptoms can persist long after fever and more severe manifestations resolve.

Results of a new survey from the national Centers for Disease Control and Prevention allows pharmacists to give a better response to the question: When will I get back to normal?

According to the multistate telephone survey of symptomatic adults who had a positive outpatient test result for SARS-CoV-2 infection, 35% had not returned to their usual state of health when interviewed two to three weeks after testing. Persistence of ill health was even common among younger people, 20% of respondents 18–34 years with no chronic medical conditions said they had not returned to their usual state of health.

“COVID-19 can result in prolonged illness, even among young adults without underlying chronic medical conditions. Effective public health messaging targeting these groups is warranted,” according to the report in the Morbidity & Mortality Weekly Report.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm?s_cid=mm6930e1_e&deliveryName=USCDC_921-DM33740

Targeted for telephone interviews from April 15–June 25, 2020, were a random group of adults who had a first positive reverse transcription–polymerase chain reaction (RT-PCR) test for SARS-CoV-2, the virus that causes COVID-19, at an outpatient visit at one of 14 U.S. academic health care systems in 13 states.

With interviews conducted 14–21 days after the test date, respondents were queried about demographic characteristics, baseline chronic medical conditions, symptoms present at the time of testing, whether those symptoms had resolved by the interview date, and whether they had returned to their usual state of health at the time of interview.

Results indicate that, among 292 respondents, 94% (274) reported experiencing one or more symptoms at the time of testing. In addition, 35% of these symptomatic respondents reported not having returned to their usual state of health by the date of the interview, which was a median 16 days from testing date. That was the case with 26% among those aged 18–34 years, 32% among those aged 35–49 years, and 47% among those aged 50 or older.

The CDC reported that, among respondents reporting cough, fatigue, or shortness of breath at the time of testing, 43%, 35%, and 29%, respectively, continued to experience these symptoms at the time of the interview.

Among the 274 symptomatic outpatients, the median number of symptoms was seven of 17 listed in the interview tool (IQR = 5–10), with fatigue (71%), cough (61%), and headache (61%) those most commonly reported. Fever and chills reported  on the day of testing were resulted in nearly all -- 97% and 96%, respectively – by the time of the interview.

Even among respondents who reported returning to their usual state of health, 34% (59 of 175) still reported one or more of the 17 queried COVID-related symptoms at the time of the interview.

“Most studies to date have focused on symptoms duration and clinical outcomes in adults hospitalized with severe COVID-19,” researchers explain. “This report indicates that even among symptomatic adults tested in outpatient settings, it might take weeks for resolution of symptoms and return to usual health.”

In contrast, more than 90% of outpatients with influenza recover within approximately two weeks of having a positive test result.

“Older age and presence of multiple chronic medical conditions have previously been associated with illness severity among adults hospitalized with COVID-19; in this study, both were also associated with prolonged illness in an outpatient population,” the authors add, although race/ethnicity did not appear to play a role.